Abstract
Context: Breakthroughs in the development of effective medications for a number of psychiatric disorders have led to increased use of these compounds in the treatment of children. Objectives: To understand the use of psychotropic medications in the treatment of children, a state-wide study was undertaken based on the data collected in a large planning study. Data and Setting: A stratified random sample of 10 different program types in New York State produced data on children served in different specialty mental health services. Participants: Randomly selected cases were reviewed at a randomly selected sites to generate a sample of 1592 cases on which data were collected on clinical presentation and service use, including psychotropic medication prescriptions. Main Outcome Measures: The Child and Adolescent Needs and Strengths (CANS-MH) tool was used to provide a reliable review of clinical indicators. Results: Psychotropic medication use is common in the children's public mental health service system in New York. Most children served in high intensity settings receive medication as a part of their treatment. It appears that most prescriptions for stimulants and antidepressants are consistent with either diagnostic or symptom indications. Many children with these indications are not on medications. On the other hand, a large number of children without evidence of psychosis receive antipsychotic medications. Conclusion: The evidence suggests that stimulant and antidepressant are not over-prescribed. However, the use of antipsychotic medications for other indications is a priority for further research.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
REFERENCES
Anderson, RL, Lyons, JS, Giles, DM, Price, JA, Estes, G. Examining the Reliability of the Child and Adolescent Needs and Strengths-Mental Health (CANS-MH) Scale from two perspectives: A comparison of clinician and researcher ratings. Journal of Child and Family Studies, 12, 279-289, 2003.
Buitelaar, JK. Open-label treatment with risperidone of 26 psychiatrically-hospitalized children and adolescents with mixed diagnoses and aggressive behavior. Journal of Child & Adolescent Pharmacology, 10, 19-26, 2000.
Burns, BJ, Hoagwood, K, Mrazek, PJ. Effective treatment for mental disorders in children and adolescents. Clinical Child and Family Psychology Review, 2, 199-254, 1999.
Campbell, M, Cueva, JE. Psychopharmacology in child and adolescent psychiatry: A review of the past seven years. Part II. Journal of the American Academy of Child and Adolescent Psychiatry, 34, 1262-1272, 1995.
Gadow, KD. An overview of three decades of research in pediatric psychopharmacoepidemiology. Journal of Child and Adolescent Psychopharmacology, 7, 219-236, 1997.
Geller, B. Psychopharmacology of children and adolescents: pharmacokinetics and relationships of plasma/serum levels to response. Psychopharmacology Bulletin, 27, 401-409, 1991.
Gracious, BL, Findling, RL. Antipsychotic medications for children and adolescents. Pediatric Annals, 30, 138-145, 2001.
Green, WH. Child and adolescent clinical psychopharmacology. 3rd Edition, Philadelphia, PA: Lippinott, Williams, & Wilkins, 2001.
Hoagwood, K, Burns, BJ, Kiser, L, Ringeisen, H, Schoenwald, SK. Evidence-based practice in child and adolescent mental health services. Psychiatric Services, 52, 1179-1189, 2001.
Hoagwood, K, Jensen, PS, Feil, M, Vitiello, B, Bhatara, VS. Medication management of stimulants in pediatric practice settings: a national perspective. Journal of Developmental & Behavioral Pediatrics, 21, 322-331, 2000.
Jensen, PS. Ethical and pragmatic issues in the use of psychotropic agents in young children. Canadian Journal of Psychiatry—Reveu Canadienne de Psychiatrie, 43, 585-588, 1998.
Jensen, PS, Bhatara, VS, Vitiello, B, Hoagwood, K, Feil, M, Burke, LB. Psychoactive medication prescribing practices for U.S. Children: Gaps between research and clinical practice. Journal of the American Academy of Child and Adolescent Psychiatry, 38, 557-565, 1999.
Kaplan, SL, Simms, RM, Busner, J. Prescribing practices of outpatient child psychiatrists. Journal of the American Academy of Child and Adolescent Psychiatry, 33, 35-44, 1994.
Kazdin, AE, Weisz, JR. Identifying and developing empirically supported child and adolescent treatments. Journal of Consulting and Clinical Psychology, 66, 19-36, 1998.
Kelleher, KJ, Hohmann, AA, Larson, DB. Prescription of psychotropics to children in office-based practice. American Journal of Diseases of Children, 143, 855-859, 1989.
Lyons, JS, Shallcross, H. The needs and strengths of children and adolescents served by the public mental health system in New York State. A report to the New York Office of Mental Health, February, 2001.
Lyons, JS, Weiner, DA, Lyons, MB. Measurement as Communication: the Child and Adolescent Needs and Strengths tool. In M. Marinsh (Ed.). The use of psychological testing for treatment planning and outcome assessment. 3rd Edition, volume 2, Mahwah, NJ: Lawrence Erlbaum Associates, Inc., 2004.
National Institute of Health Consensus Development Conference Statement: Diagnosis and Treatment of Attention-Deficit/Hyperactivity Disorder (ADHD). Journal of the American Academy of Child and Adolescent Psychiatry, 39, 182-193, 2000.
Pappadopulos, E, Jensen, PS, Schur, SB, MacIntyre, II, JC, Ketner, S, Van Orden, K, Sverd, J, Sardana, S, Rube, D. “Real world” atypical antipsychotic prescribing practices in public child and adolescent inpatient settings. (Under review).
Rawal, PH, Lyons, JS, MacIntyre, JC, Hunter, JC. Regional variation and clinical indicators of antipsychotic use in residential treatment: A four state comparison. Journal of Behavioral Health Services & Research, 21, 178-188, 2004.
U. S. Surgeon General. Report of the United States Surgeon General's Conference on Children's Mental Health: A National Action Agenda, Department of Health and Human Services, Washington, DC, 2001.
Vitiello, B, Jensen, PS. Developmental perspectives in pediatric psychopharmacology. Psychopharmacology Bulletin, 31, 75-81, 1995.
Weisz, JR, Jensen, PS. Efficacy and effectiveness of child and adolescent psychotherapy and pharmacotherapy. Mental Health Services Research, 1(3), 125-157, 1999.
Zito, JM, Safer, DJ, DosReis, S, Gardner, JF, Boles, M, Lynch, F. Trends in the prescribing of psychotropic medications to preschoolers. Journal of the American Medical Association, 283(8), 1025-1030, 2000.
Zito, JM, Safer, DJ, DosReis, S, Gardner, JF, Magder, L, Soeken, K, Boles, M, Lynch, F, Riddle, MA. Psychotropic practice patterns for youth: a 10 year perspective. Archives of Pediatric Adolescent Medicine, 157, 17-25, 2003.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Lyons, J.S., MacIntyre, J.C., Lee, M.E. et al. Psychotropic Medications Prescribing Patterns for Children and Adolescents in New York's Public Mental Health System. Community Ment Health J 40, 101–118 (2004). https://doi.org/10.1023/B:COMH.0000022731.65054.3e
Issue Date:
DOI: https://doi.org/10.1023/B:COMH.0000022731.65054.3e